Ticket for Outdoor Patient
| Ward No. 8 | U-PHC No. | Registration No. 00259 | Date 09/08/2018 |
| Token No | SM/18-19/4021 22/11/2018 | Serial | 016 Last Visit: 10/05/2019 |
| Patient Name | Mr. AJIT GHORUI | Contact No | 8697015494 |
| Address | 243, VIVEKANAND ROAD , SHEWRAPHULI | Age | 68 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 73 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||